title: Contrasting trajectories of heroin, cocaine, and methamphetamine use.
abstract: Current literature has shown that heroin addiction is characterized by long periods of regular use persisting over the life course, whereas the course of stimulant use is less understood. The current study examined long-term trajectories of drug use for primary heroin, cocaine (crack/powder cocaine), and methamphetamine (meth) users. The analyses used data from five studies that collected longitudinal information using the Natural History Instrument, including 629 primary heroin users, 694 cocaine users, and 474 meth users. Drug use trajectories over the 10 years since initiation demonstrated the persistence of use over time for all three drugs, with heroin use at the highest level (13 to 18 days per month), cocaine at the lowest level (8 to 11 days), and meth in between (approximately 12 days per month). Application of growth mixture models revealed five distinctive groups: Consistently High Use (n = 545), Increasing Use (n = 260), Decreasing Use (n = 254), Moderate Use (n = 638), and Low Use (n = 100). Heroin users were disproportionately overrepresented in the Consistently High Use group and underrepresented in the Low Use group; cocaine and meth users were mostly in the Moderate Use group. Users in the High Use group also had earlier onsets of drug use and crime, longer incarceration durations, and were the least employed. Clinical/service policy and practice need to recognize and adapt to the specific patterns and needs of users of different drugs while being mindful of the stage drug users are at in their life course.
authors.affiliation: UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 1640 South Sepulveda Boulevard, Suite 200, Los Angeles, CA 90025, USA. yhser@ucla.edu
authors.forename: Yih-Ing
authors.initials: YI
authors.lastname: Hser
authors.forename: David
authors.initials: D
authors.lastname: Huang
authors.forename: Mary-Lynn
authors.initials: ML
authors.lastname: Brecht
authors.forename: Libo
authors.initials: L
authors.lastname: Li
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Evans
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D019969:Amphetamine-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D002140:California; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D003415:Crime / Q000517:prevention & control / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008694:Methamphetamine; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data
chemical_list: D008694:Methamphetamine